Reduced sTWEAK and Increased sCD163 Levels in HIV-Infected Patients: Modulation by Antiretroviral Treatment, HIV Replication and HCV Co-Infection

Luis M Beltrán,Rafael Moreno-Luna,Juan Antonio Moreno,Sara Ferrando-Martinez,Rocío Muñoz Hernández,Jesús Egido,Manuel Leal Noval,Rebeca S De Pablo Bernal,José R Villar,Miguel Genebat,Luis M Blanco-Colio,José S García Morillo,Clive M Gray

doi:10.1371/journal.pone.0090541

Abstract

BackgroundPatients infected with the human immunodeficiency virus (HIV) have an increased risk of cardiovascular disease due to increased inflammation and persistent immune activation. CD163 is a macrophage scavenger receptor that is involved in monocyte-macrophage activation in HIV-infected patients. CD163 interacts with TWEAK, a member of the TNF superfamily. Circulating levels of sTWEAK and sCD163 have been previously associated with cardiovascular disease, but no previous studies have fully analyzed their association with HIV.ObjectiveThe aim of this study was to analyze circulating levels of sTWEAK and sCD163 as well as other known markers of inflammation (hsCRP, IL-6 and sTNFRII) and endothelial dysfunction (sVCAM-1 and ADMA) in 26 patients with HIV before and after 48 weeks of antiretroviral treatment (ART) and 23 healthy subjects.ResultsPatients with HIV had reduced sTWEAK levels and increased sCD163, sVCAM-1, ADMA, hsCRP, IL-6 and sTNFRII plasma concentrations, as well as increased sCD163/sTWEAK ratio, compared with healthy subjects. Antiretroviral treatment significantly reduced the concentrations of sCD163, sVCAM-1, hsCRP and sTNFRII, although they remained elevated when compared with healthy subjects. Antiretroviral treatment had no effect on the concentrations of ADMA and sTWEAK, biomarkers associated with endothelial function. The use of protease inhibitors as part of antiretroviral therapy and the presence of HCV-HIV co-infection and/or active HIV replication attenuated the ART-mediated decrease in sCD163 plasma concentrations.ConclusionHIV-infected patients showed a proatherogenic profile characterized by increased inflammatory, immune-activation and endothelial-dysfunction biomarkers that partially improved after ART. HCV-HIV co-infection and/or active HIV replication enhanced immune activation despite ART.

Highlights

Patients with human immunodeficiency virus (HIV) infection have a higher risk of developing cardiovascular disease than does the general population [1,2,3]
Antiretroviral treatment significantly reduced the concentrations of sCD163, sVCAM-1, hsCRP and sTNFRII, they remained elevated when compared with healthy subjects
The use of protease inhibitors as part of antiretroviral therapy and the presence of hepatitis C virus (HCV)-HIV co-infection and/or active HIV replication attenuated the ART-mediated decrease in sCD163 plasma concentrations

Summary

Introduction

Patients with human immunodeficiency virus (HIV) infection have a higher risk of developing cardiovascular disease than does the general population [1,2,3]. HIV infection induces persistent inflammation and immune activation, endothelial dysfunction, lipid disorders and direct. Identifying biomarkers for HIV patients at higher cardiovascular risk may be of great interest and could improve cardiovascular risk predictions by traditional stratification scales. Patients infected with the human immunodeficiency virus (HIV) have an increased risk of cardiovascular disease due to increased inflammation and persistent immune activation. Circulating levels of sTWEAK and sCD163 have been previously associated with cardiovascular disease, but no previous studies have fully analyzed their association with HIV

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